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Prescription Stimulants

Risk factors, effects on the body and mind, and how to start recovery and treatment

Recovery from prescription stimulant misuse or dependency is possible. Seek out a licensed medical professional who can help you slowly reduce the amount of the drug you’re taking. Obtain additional counseling from a mental health professional, who can further your recovery. Take comfort from supportive family members and friends, including peers going through similar experiences.

The idea that a stimulant — a drug that boosts energy — could help restless children calm down and learn may seem counterintuitive. Yet it’s true. Following this discovery in 1937, the medical community has prescribed stimulants to successfully manage various behavioral and medical conditions, first in children and later in adults.

Today, the United States is among the countries with the highest rates of prescription stimulant use. Stimulants are most often prescribed to treat attention deficit hyperactivity disorder (ADHD) in children as young as 6, college kids, and adults ages 20 and older. Clinicians also prescribe these medications to people diagnosed with the sleep disorder narcolepsy or with depression.

An estimated 16 million adults in the U.S. — or 6.6% of people 18 and older — report using prescription stimulants, which are commonly known by the brand names of Adderall (dextroamphetamine), Concerta (methylphenidate HCl), Dexedrine (dextroamphetamine), Provigil (modafinil), and Ritalin (methylphenidate).

U.S. adults now receive more than half of all stimulant prescriptions, and most use the medication as intended. (In fact, there are indications that withholding stimulant therapy from people with ADHD may be linked to later substance use disorder.) However, a portion of adults misuse or become dependent on stimulants. Stimulant use disorder can lead to serious problems.

Recovery is possible.

1. Potential causes and signs of misuse

A problem with stimulants may develop if you’re misdiagnosed with ADHD and prescribed the drug in error, or if you take prescription stimulants though you don’t need them (this is known as off-label use). A history of substance use disorder might also lead you to seek out these drugs.

Your initial reasons for using the drug could be to enhance concentration during class, to get high (taking the drug alone or with other drugs like opioids or sedatives), or to lose weight. You might think taking stimulants is harmless and that you can stop when you achieve your “goal” — whether a higher grade point average, a more exciting night out with friends, or looser-fitting clothing.

Yet taking stimulants off-label is likely to lead to other, unpleasant outcomes. With misuse comes a host of side effects that feel physically uncomfortable and can become dangerous. In addition, misuse has been linked to unhealthy practices: One study of a group of youths who misused stimulants found the misuse was associated with smoking cigarettes and binge drinking.

Other possible effects include aggression, anorexia, anxiety, decreased appetite, increased pulse rate and wakefulness, irritability, memory loss, paranoia, psychosis, and tremors. And students are apt to do worse in school. Those who take high doses of stimulants can experience accidents, irregular heartbeat, elevated blood pressure, and heart failure.

In addition, your continued use of nonprescribed stimulants can lead to tolerance for the drug. You may repeatedly ask your physician to refill prescriptions to meet the need for higher doses of the drug; resort to snorting the drug, which causes nosebleeds; or start injecting the drug, which increases your risk of overdose and infection.

These are all signs you depend on the drug, have a substance use disorder, and will experience withdrawal symptoms when you try to stop.

If you or someone in your family has a history of substance use disorder, you may be more likely than others to misuse prescription stimulants.

2. Prescription stimulant withdrawal

Withdrawal from prescription stimulants depends on the type of compound you’ve been taking and for how long, the dosage, the method of delivery (for instance, tablet or injection), and whether you mix the stimulant with other drugs. Most guidelines recommend gradually decreasing the use of a prescription stimulant rather than suddenly stopping.

Here are symptoms of withdrawal from the more commonly used prescription stimulants:

  • Dextroamphetamine (Adderall, Dexedrine): Typically lasting between five days and three weeks, symptoms include irritability, aches and pains, depressed mood, and impaired social functioning. Other withdrawal symptoms include severe depression and extreme tiredness.
  • Methylphenidate (Concerta, Ritalin): Symptoms include decreased ability to focus, depression, nausea and vomiting, listlessness, irritability, and increased anxiety.
  • Modafinil (Provigil): One withdrawal symptom included sleepiness in patients with narcolepsy.

If you’re prescribed a stimulant, take only the required dosage. Don’t share any part of your prescription with loved ones or friends — even if they seem to be anxious over a recent life event, academics, or body image. You should also keep your prescription medications safe, for instance not bringing them to study sessions or to social events.

Stimulants and the brain. Brain scans of people with symptoms of ADHD — such as inattention or hyperactivity — tend to show lower levels of the chemical dopamine, which plays a role in how we regulate our emotions. The therapy for a diagnosis of ADHD is often a prescription stimulant. The stimulant’s effects on that chemical in our brain helps us focus on daily tasks. But the nonmedical use of a prescription stimulant causes problems by increasing the amount of dopamine in the body. This produces a “high” that risks creating a dependency on a drug we don’t need. And this misuse can lead to serious health risks.

Getting treatment for prescription stimulant misuse

If you recognize signs of prescription stimulant misuse or dependency in yourself, take these steps toward recovery:

  • Consult a medical professional: Start your recovery by consulting with a licensed medical professional, who can monitor you as you gradually reduce the amount of stimulant you’re taking until you achieve abstinence. Your provider may also suggest you combine this step with therapy to manage withdrawal symptoms, prevent relapse, and modify the thinking that led you to misuse prescription stimulants.
  • Medication: Some studies indicate that misuse of stimulants can be effectively managed with Bupropion (known by the brand names of Wellbutrin and Zyban) when combined with behavioral treatments. However, the FDA has not approved a medication for treating prescription stimulant misuse or stimulant use disorder. If you overdose on a prescription stimulant, a licensed medical provider may administer a benzodiazepine.
  • Therapy: Cognitive behavioral therapy and other behavioral therapies show promise in treating stimulant use disorder. Consider also seeking out peer support groups, which can be safe places to talk with others dealing with similar pressures related to academics, body image, family, work, or other issues.

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